Provider Demographics
NPI:1992531198
Name:MOSHER, REINIAN LEE (LMSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:REINIAN
Middle Name:LEE
Last Name:MOSHER
Suffix:
Gender:F
Credentials:LMSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 WESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13211-1228
Mailing Address - Country:US
Mailing Address - Phone:315-569-1113
Mailing Address - Fax:
Practice Address - Street 1:13 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:SHERBURNE
Practice Address - State:NY
Practice Address - Zip Code:13460-9505
Practice Address - Country:US
Practice Address - Phone:607-674-7311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0983101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical